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A newly released Harvard study found that former NFL players who have experienced head injuries (concussions) may be more likely to also experience low testosterone and erectile dysfunction (ED).

The study, published in the JAMA Neurology was based on a survey of more than 3,400 NFL players. Researchers with the Harvard T.H. Chan School of Public Health and Harvard Medical School noted that this represents the largest study cohort of former professional football players to date.

The survey was conducted between 2015 and 2017.

For the survey, the participants were asked to report on how often blows to their head or neck caused them to feel dizzy, nauseated or disoriented. They were also asked if any jolts led to experiencing headaches, loss of consciousness or vision disturbances. All of these are indicators of a concussion. The responders were grouped into four categories by the number of concussive symptoms, researchers explained.

Next, the former players were asked whether a clinician had recommended medication for either low testosterone or ED, and whether they were currently taking such medications.

By the end of the survey, researchers found those who reported the most concussion symptoms were two-and-a-half times more likely to say they were either recommended to take, or are currently taking, medication for low testosterone compared to those who reported the fewest symptoms. Similarly, those who reported the most concussion symptoms were roughly two times more likely to say the same about ED medication.

“Former players with ED may be relieved to know that concussions sustained during their NFL careers may be contributing to a condition that is both common and treatable.” said, Rachel Grashow, a researcher at the Harvard T.H. Chan School of Public Health and the study’s lead author.

Overall, 18 percent of participants reported low testosterone, and 23 percent reported ED. Nearly 10 percent said they experienced both.

Though the findings are observational and do not prove a definitive link between head trauma and ED, the results reveal an intriguing and powerful link between the history of the player’s concussions with hormonal and sexual dysfunctions, regardless of the player’s age.

Injury to the pituitary gland, the small organ at the base of the brain that’s responsible for hormone production could affect testosterone levels and ED, researchers explained as a possible explanation.

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